Exploring the role of binge eating symptoms in the association between ADHD and BMI: a twin study

You, Yuan, McAdams, Tom A., Oginni, Olakunle, Liu, Chaoyu, Herle, Moritz and Zavos, Helena M.S. 2026. Exploring the role of binge eating symptoms in the association between ADHD and BMI: a twin study. Psychological Medicine 56 , e308. 10.1017/s0033291726105935

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Abstract

Background ADHD has been associated with BMI, across the lifespan. A possible mechanism linking ADHD and BMI is binge eating symptoms. Previous research has found associations between ADHD, binge eating symptoms, and BMI. However, the role of genetic and environmental influences on these associations remains unclear. Method We utilized data from the Twins Early Development Study, comprising 4,363 monozygotic and 8,575 dizygotic twin pairs. ADHD symptoms in childhood and adolescence were assessed using parent-reported questionnaires. Adult ADHD symptoms were measured using both self-report and parent-report questionnaires. Phenotypic mediation models examined whether binge eating symptoms mediated the association between ADHD and BMI, without controlling for genetic confounding. Subsequently, the etiological architecture underlying the associations among the three traits across childhood, adolescence, and adulthood were investigated by incorporating genetic and environmental influences into the models. Results Binge eating symptoms significantly mediated the association between ADHD symptoms and BMI in both adolescence and adulthood. However, these mediation effects were no longer present once genetic and environmental influences were incorporated into the models. The best-fitting model in childhood, adolescence, and adulthood was Cholesky decomposition models, where covariance between traits was explained by shared etiology. Conclusions This twin study reveals shared liability across ADHD, binge eating symptoms, and BMI. The mediating role of binge eating symptoms in the relationship between ADHD symptoms and BMI was largely confounded by shared genetic influences. Intervention strategies could focus more on common underlying behavioral and self-regulatory mechanisms across these traits, as well as placing more emphasis on symptom patterns within families.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Schools > Medicine
Publisher:	Cambridge University Press
ISSN:	0033-2917
Date of First Compliant Deposit:	5 October 2026
Date of Acceptance:	14 August 2026
Last Modified:	05 Oct 2026 10:15
URI:	https://orca.cardiff.ac.uk/id/eprint/189981

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